血浆致动脉粥样硬化指数与冠状动脉慢性完全闭塞病变的相关性

Association of atherogenic index of plasma with chronic total occlusion

目的观察冠状动脉粥样硬化性心脏病(CHD)患者血浆致动脉粥样硬化指数(AIP)与冠状动脉慢性完全闭塞(CTO)病变的相关性。方法连续收集2009年11月至2020年7月于中国人民解放军空军军医大学第一附属医院初诊的CHD患者2754例,评估患者冠状动脉病变狭窄严重程度,并将其分为非CTO组(1904例)和CTO组(850例)。记录两组患者住院期间的基线资料并计算AIP和Gensini评分(GS)。使用受试者工作特征(ROC)曲线计算AIP的曲线下面积,得到CTO病变诊断的截断值;并使用单因素与多因素分析方法对CTO病变的危险因素进行分析。结果用ROC曲线测得AIP的曲线下面积为0.580(95%CI 0.556~0.604,P<0.001),敏感度为0.612,特异度为0.528。CTO病变诊断的截断值为AIP=0.140。经过多因素Logistic回归分析后发现,总胆固醇水平升高(OR 1.200,95%CI 1.007~1.338,P=0.001)、低密度脂蛋白胆固醇水平升高(OR1.323,95%CI 1.158~1.511,P<0.001)、AIP>0.140(OR 1.540,95%CI 1.257~1.887,P<0.001)是CTO病变的危险因素。结论AIP升高与CTO病变有相关性,其对于CTO病变有较好的预测价值。

Objective To observe the correlation between atherogenic index of plasma(AIP)and chronic total occlusion(CTO)in coronary atherosclerotic heart disease(CHD)patients.Methods A total of 2754 patients with initial CHD in the First Affiliated Hospital of Air Force Military Medical University from November 2009 to July 2020 were consecutively enrolled to evaluate the severity of coronary artery stenosis and divided into non-CTO group(1904 cases)and CTO group(850 cases).Baseline data during hospitalization were recorded,AIP and Gensini score(GS)were calculated.The area under the curve of AIP was calculated using receiver operating characteristic(ROC)curve,and the cut off value of CTO diagnosis was obtained.Univariate and multivariate analyses were used to analyze risk factors.Results ROC curve measured area under the curve of AIP was 0.580(95%CI 0.556-0.604,P<0.001),sensitivity was 0.612,and specificity was 0.528.The cut-off value of CTO diagnosis was AIP=0.140.According to multivariate analysis,it was found that the increased level of TC(OR 1.200,95%CI 1.007-1.338,P=0.001),LDL-C(OR 1.323,95%CI 1.158-1.511,P<0.001)and AIP>0.140(OR 1.540,95%CI 1.257-1.887,P<0.001)were the risk factors for CTO.Conclusions Elevated AIP is associated with CTO,and it has good predictive value for CTO disease.